Elevated mean pulmonary artery pressure in patients with mild-to-moderate mitral stenosis: a useful predictor of worsening renal functions?

Zorkun, Cafer; Amioglu, Gullu; Bektaşoğlu, Gökhan; Zorlu, Ali; Ekinözü, İ̇smail; Turgut, Okan Onur; Tandoğan, İzzet; Yılmaz, Mehmet

doi:10.5152/akd.2013.144

Cited by 2 publications

(2 citation statements)

References 35 publications

(40 reference statements)

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“…A recent study found correlations between pulmonary hypertension and worsening renal function in patients with mild-to-moderate mitral stenosis (16). …”

Section: Discussionmentioning

confidence: 99%

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Chronic kidney disease: Prognostic marker of nonfatal pulmonary thromboembolism

Ouatu¹,

Floria²,

Ionescu³

et al. 2015

Anatol J Cardiol

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Objective:Renal dysfunction is associated with increased cardiovascular morbidity and mortality. The alteration in renal function as a marker of mortality in pulmonary thromboembolism (PTE) has not been studied extensively.Methods:Four hundred four consecutive patients diagnosed with non-high-risk PTE (without cardiogenic shock or blood pressure <90 mm Hg) were prospectively enrolled in the study between 2005-2010. Kidney function, based on glomerular filtration rate (GFR), calculated by the simplified modification in diet in renal disease (MDRD) equation (sMDRD); troponin I; B-type natriuretic peptide (BNP); and echocardiographic markers of right ventricular (RV) function were determined in survivors versus non-survivors after a 2-year follow-up.Results:GFR was significantly lower in non-survivors than in survivors: 51.85±19.08 mL/min/1.73 m2 and 71.65±23.21 mL/min/1.73 m2, respectively (p=0.000). The highest 2-year mortality rate (20%) was recorded in patients with moderate renal dysfunction associated with RV dysfunction. Using multivariate analysis, we found that GFR is an independent predictor of 2-year mortality (OR 0.973, 95% CI: 0.959-0.987, p=0.000), besides troponin I, dyslipidemia, acceleration time of pulmonary ejection, pericardial effusion, and BNPConclusion:The association of renal dysfunction with right ventricular dysfunction in patients with non-fatal pulmonary thromboembolism resulted in high mortality. Renal dysfunction, assessed by glomerular filtration rate, may be used in the risk stratification of patients with non-high-risk pulmonary thromboembolism, besides troponin I, BNP and right ventricle echocardiographic dysfunction markers.

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“…A recent study found correlations between pulmonary hypertension and worsening renal function in patients with mild-to-moderate mitral stenosis (16). …”

Section: Discussionmentioning

confidence: 99%

“…Renal dysfunction is known as an independent risk factor for morbidity and mortality in various other conditions, such as acute coronary syndromes and heart failure ( 12 - 15 ). A recent study found correlations between pulmonary hypertension and worsening renal function in patients with mild-to-moderate mitral stenosis ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

Chronic kidney disease: Prognostic marker of nonfatal pulmonary thromboembolism

Ouatu¹,

Floria²,

Ionescu³

et al. 2015

Anatol J Cardiol

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Infective endocarditis in Turkey: changing trends in epidemiology

İpek¹,

Güray²,

Güray³

2014

Anadolu Kardiyol Derg

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We read with a great interest the article by Elbey et al. (1) that was published in September issue of The Anatolian Journal of Cardiology 2013; 13: 523-7. In this multicenter study, the authors evaluated the epidemiologic factors that contribute infective endocarditis (IE) along with the clinical and echocardiographic characteristics of the patients. They concluded that the main predisposing factor was rheumatic heart disease, patients were younger in contrast to western countries, staphylococci species were the major pathogens and in-hospital mortality rates were still high.The exclusive feature of this study was the multicenteral participation. The previous researches of IE conducted in Turkish population were prominently single center studies (2-4). Although Leblebicioğlu et al. (4) published a multicenter study previously; they enrolled fewer subjects.In our opinion, the most common predisposing factor should have been interpreted as prosthetic valve instead of rheumatic heart disease according to given results (30% vs. 28%). Comparing to previous multicenter study by Leblebicioğlu et al. (4), the incidence of prosthetic valve endocarditis was increased substantially (30% vs. 17 %). According to the data from a single center in Turkey, the rate of prosthetic valve involvement was as higher as 44% (2). In the present study, there were 15 cases of device related endocarditis. The increasing frequency of these newer etiologic factors may have altered the distribution of the causative microbiological agents; leading a decline in streptococci infection and increase in enterococci species.Apart from traditional predisposing conditions, up-to-date etiologic factors such as intravenous drug use, immunosuppressive disorders, hemodialysis or the presence of intravascular catheters should also have been evaluated. Despite their increasing prevalence in the western countries, the data are scarce about the rates of these predisposing factors in Turkish population.As stated in the limitation part, the use of transesophageal echocardiography seems lower. Given the higher rates of congestive heart failure (33%) and severe symptoms (NYHA 3/4: 51%) in the patient population; the mechanic complications may have been overlooked. Based on its superior abilities in diagnose and follow-up -especially in detecting mechanic complications and measuring vegetation size-, the current guidelines recommend the use of transesophageal echocardiography even in the setting of positive transthoracic echocardiography (5).The rates of negative blood culture still remain higher. The modified Duke criteria is mainly based on blood culture results; thus negative blood culture causes delays in diagnosis and may lead inappropriate treatments. As specified in the discussion part, in most of the cases, the possible reason of this finding would be commencing antibiotics before obtaining blood cultures. The predisposing patients should be informed and the clinicians should be educated about the importance of the blood cultures in order to diagnose an...

show abstract

Elevated mean pulmonary artery pressure in patients with mild-to-moderate mitral stenosis: a useful predictor of worsening renal functions?

Cited by 2 publications

References 35 publications

Chronic kidney disease: Prognostic marker of nonfatal pulmonary thromboembolism

Chronic kidney disease: Prognostic marker of nonfatal pulmonary thromboembolism

Infective endocarditis in Turkey: changing trends in epidemiology

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